Gynecologists Don't Talk To Women About Sex Enough, Study Claims

If there's one place you should feel comfortable talking about sex, it's probably your OB-GYN's office. After all, your doctor theoretically chats with other patients about all kinds of awkward topics all day long. Except that she or he doesn't, according to a recent study. Researchers at the University of Chicago found that OB-GYNS actually don't engage their patients in conversations about sex as often as women might hope -- and need.

The researchers surveyed over 1,100 OB-GYNs to find out how they communicate with patients. The study, which was published in the Journal of Sexual Medicine, found that while two thirds of the doctors ask their patients how sexually active they are, only 40 percent inquire about sexual problems or dysfunction. Just 28 percent routinely ask about sexual orientation, an area the researchers suggested should be researched further. (If doctors assume heterosexuality, they might alienate lesbian or bisexual patients or end up misinterpreting symptoms or misdiagnosing patients.) On top of that, only 29 percent of doctors make a habit of asking patients whether their sex life is satisfying.

"Sexuality is a key component of a woman's physical and psychological health," Stacy Tessler Lindau, an associate professor University of Chicago Medicine and the study's lead author, said in a press release. "Obviously, OB-GYNs are well positioned among all physicians to address female sexual concerns. Simply asking a patient if she's sexually active does not tell us whether she has good sexual function or changes in her sexual function that could indicate underlying problems."

But the prevalence of sexual concerns doesn't coincide with women feeling comfortable asking their doctors about those issues: In the study on pain during intercourse, only two percent of women sought help from their physicians.

"Many women are suffering in silence," Lindau said. "Patients are often reluctant to bring up sexual difficulties because of fear the physician will be embarrassed or will dismiss their concerns. Doctors should be taking the lead. Sexual history-taking is a fundamental part of gynecologic care. Understanding a patient's sexual function rounds out the picture of her overall health and can reveal underlying issues that may otherwise be overlooked."

As NPR pointed out, the range of things that could go by the wayside if doctors don't encourage their patients to be forthcoming about sex ranges from sexually transmitted diseases to pelvic inflammatory disease to the ways in which various medicines might be involved in sexual dysfunction.

The good news, according to Lindau, is that the Internet is empowering women to be pro-active about their sexual health, and seeking out communities online may help them overcome some of the angst involved in approaching their doctors. Still, that's probably no substitute for talking to your OB-GYN, however uncomfortable that may feel.

"If you are waiting for the doctor to start the conversation, it may never happen. Communication is key," Lindau said.

RELATED SLIDESHOW: 6 Women's Health Conditions You Can Test For At Home

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Although you may know the symptoms of a yeast infection well enough that you don't need a test to tell if you have one, home tests do exist. Yeast infection tests measure the pH levels of your discharge to help you discern whether your symptoms are indicative of a yeast infection -- which can be easily treated with over-the-counter medication -- or something more serious.
These tests are most useful if you are worried that your symptoms might signal something other than a yeast infection. "Women oftentimes know they have a yeast infection without doing a self test," Knobel said. She also told The Huffington Post that using an over-the-counter treatment like Monistat or Vagistat-1 can be a test in and of itself. "If [these treatments] don't work, follow up with your family doctor," she said.

If you want to get pregnant, using a method of ovulation prediction can help you determine when the optimal time is to try each month. One such method is using an Ovulation Predictor Kit (OPK). These kits monitor the levels of the luteinizing hormone (LH) in your urine, which increase a day or two before ovulation begins. However, OPKs aren't so useful for women who have polycystic ovary syndrome, as one of the symptoms is elevated LH.
Another at-home method for predicting fertility involves charting your ovulation by taking your Basal Body Temperature (BBT) each day, right after you get out of bed. The reason that tracking your BBT can be effective is because during ovulation, progesterone is released, which leaves your body a little bit (.1 or .2 degrees) warmer right after ovulation. By tracking these temperature changes over the course of a couple of months, a woman can discern her body's temperature patterns and determine when she may be most fertile.
Although these tests are by no means foolproof, Dr. Knobel said that she has no qualms recommending them: "They're pretty accurate and they're safe," she said. However, Knobel still recommended that women discuss issues of fertility with a physician, as lifestyle factors such as diet, exercise and medications can all have a big impact when it comes to getting pregnant.

Urinary Tract Infections are anything but pleasant. From burning to pelvic pain, UTIs are something most women want to identify and treat ASAP. Most at-home UTI tests are similar to what a doctor might use to confirm that you have an infection, although a physician might follow up with a full culture, Knobel said. As reported in Redbook magazine, after peeing on a dipstick, the test measures whether white blood cells, nitrates and proteins are present in your urine. These are all signals of infection.
However, at-home tests function only as a first step. In order to get a prescription for antibiotics to treat the UTI and to determine the exact location of the infection, you'll need to contact a physician. It's important to note that home tests aren't foolproof, and that UTI symptoms could also indicate more serious conditions, such as a kidney stone or a tumor.

Perhaps the most frequently used self-administered health test, at-home pregnancy tests, are widely accepted as accurate and safe. Most of these tests are urine-based and look for the presence of the human chlorionic gonadotropin (HCG) hormone. HCG is produced in high amounts during pregnancy, beginning after a fertilized egg implants in the wall of the uterus -- which usually happens within nine days of fertilization. And according to Everyday Health, the best time to take a pregnancy test is during your first trip of the day to the bathroom.
Dr. Knobel encourages her patients to take advantage of at-home pregnancy tests. "[They] help people plan," she said. "It's great to have that little bit of advance knowledge."

Self-administered breast exams have been the subject of some controversy over the past decade. They used to be considered an essential part of breast cancer detection, but since then, research has been published showing that consistent self-checks didn't actually decrease breast cancer mortality rates. The National Institutes of Health website, MedlinePlus, recommends that women "talk to [their] health care provider about whether [they] should do breast self exams."
Knobel said that women shouldn't depend on self-checks, but said she sees no harm in doing one every few months. "It doesn't hurt to check -- just to make sure you know what your own breast tissue feels like," she said. "Knowing your own body is key."

Another common self-administered health test is an at-home glucose test -- also referred to as reflective glucose monitoring -- used by individuals with diabetes to check their blood sugar levels. An individual pricks him or herself with a small needle (termed a lancet device), usually on the side of the fingertip or on the back of the arm, and places a drop of blood into a glucose meter. According to Steven Smith, M.D., of the Mayo Clinic, once this is done, the reading will come back in about five seconds. These tests are most useful for people who take insulin to manage their diabetes.
The frequency with which this testing is done varies from person to person: "Someone might measure [their blood sugar] once or twice a week, and others might be measuring four to six times a day," Smith said. Depending on the type of glucose meter, the device may be able to store multiple readings over time so that one can develop an understanding of how his or her blood sugar levels generally fluctuate each day.
And while these sorts of tests have been around for decades, they aren't perfect. Smith said that the variation on the reading for these devices is usually around 10 percent. "[This] is usually sufficient for someone to act and make decisions, though," he said. Also important to note is that while reflective glucose monitors can be obtained without a prescription, if patients want to be reimbursed by insurance, a prescription is necessary.